NEW YORK The nation’s community pharmacists are highly trained but underutilized healthcare resources, and their full potential as contributing members of a new, more effective health-and-wellness network won’t be realized until they’re properly paid for their services, given full access to patient medical records and inducted fully into the healthcare team.

So says a new report from B. Joseph Guglielmo in the Archives of Internal Medicine. In a lengthy commentary on the role pharmacists could play in improving chronic disease management, Guglielmo noted that pharmacists won’t be able to fully engage with a more cost-effective, outcomes-based healthcare system until fundamental changes are made to the nation’s healthcare reimbursement system and collaborative practice structure.

“A growing body of research demonstrates the valuable role of pharmacists in chronic disease management in outpatient clinic settings,” Guglielmo wrote. However, he added, “it has been … difficult to achieve the full vision of the pharmacist’s role in the healthcare team in community pharmacies.

“Most community pharmacists are isolated; they lack access to medical records with important information and in which they can document their interventions for the rest of the team. Communication with other healthcare providers is intermittent and most often telephonic,” the author noted. “Critically, community pharmacies are reimbursed for drug products dispensed, not for medication therapy management provided by employee pharmacists.

“Because pharmacies staff accordingly, there is little time for pharmacists to provide these services voluntarily,” Guglielmo wrote.

It doesn’t have to be that way, Guglielmo added. He cited the Asheville Project as proof that community pharmacists can bring real cost savings and health benefits to health-plan payers and patients, provided those pharmacists are given membership in an integrated health provider network — and are adequately compensated for their time, training and professional skills to engage with patients and monitor their progress.

“In the Asheville Project, diabetic employees of the city of Asheville, N.C., as well as those from the Mission-St Joseph Health System, were offered general pharmacy care by trained community pharmacists,” the article noted. The result, according to its author: “Mean hemoglobin A1c and lipid levels improved, and the total mean direct medical costs decreased by $1,200 to $1,872 per patient per year compared with baseline.”

Akey factor in that success, Guglielmo added, is the fact that “pharmacists participating in the Asheville Project had access to medical records … and they were reimbursed for their clinical care.”

The new health-reform law will expand coverage to an additional 32 million Americans, he pointed out. However, Guglielmo noted, “Access to health care remains bureaucratic and limited.”

“Pharmacists practicing in community pharmacies, which are widely distributed throughout the United States, could potentially expand access to care, particularly in the areas of preventive medicine and chronic disease management. However, an economic model that is solely driven by prescriptions filled per day will not unleash the full potential of these well-trained but clinically underused professionals,” he reported in Archives.

In short, Guglielmo said, “It is clear that an economic model that gives community pharmacists incentives to participate in risk reduction and chronic disease management must evolve.”

Obesity costs U.S. employers billions, study finds

NEW YORK New research by Duke University found that obese workers cost U.S. employers $73.1 billion a year.

The researchers, led by Eric Finkelstein, deputy director for health services and systems research at Duke-National University of Singapore, used survey data from the 2006 Medical Expenditure Panel Survey and the 2008 U.S. National Health and Wellness Survey to determine the extent to which obesity-related health problems affected absenteeism, work productivity and medical costs. Among those with a body mass index higher than 40, or roughly 100 lbs. overweight, these costs worked out to $16,900 per capita for women and $15,500 for men.

"Much work has already shown the high costs of obesity in medical expenditures and absenteeism, but our findings are the first to measure the incremental costs of presenteeism for obese individuals separately by body mass index and gender among full-time employees," Finkelstein said.

The study was published on Oct. 8 in the Journal of Occupational and Environmental Medicine.

Jewel-Osco enters flu prevention game

ITASCA, Ill. Supervalu’s Jewel-Osco stores announced a flu prevention program with vaccinations available in all locations with a pharmacy.

Jewel-Osco said its pharmacists will offer the traditional flu vaccine, the needle-free FluMist nasal spray and the new high-dose Fluzone for patients older than 65 years, during regular pharmacy hours.

The flu vaccine is available for $26.99 for either the traditional injection or FluMist. Fluzone HD is available for $59.99. The cost of these vaccines is covered by Medicare Part B and many commercial health plans, which means that many customers may not be incurring additional costs.

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The workshops, sponsored by McKesson, have been offered by the Alexandria, Va.-based organization for more than 20 years and are slated to take place June 8-10 in Denver, Colo., and Oct. 4-6 in Boston.

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